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International Orthopaedics
Published in: International Orthopaedics 12/2014

01-12-2014 | Original Paper

A pilot study investigating the histology and growth factor content of human non-union tissue

Authors: Philipp Schwabe, Paul Simon, Zienab Kronbach, Gerhard Schmidmaier, Britt Wildemann

Published in: International Orthopaedics | Issue 12/2014

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Abstract

Purpose

The reason for the formation of an atrophic non-union is not clear and an altered vascularization as well as a deregulation of endogenous growth factors is hypothesized. To obtain more information, we analysed human non-union tissue regarding the histology and quantity of several growth factors.

Methods

Tissue from patients with an atrophic non-union (n = 44) or with a healed fracture (n = 13) was analysed. Using histological and immunohistochemical methods the tissue composition was investigated. On the protein level the amount of several growth factors important for bone healing was analysed.

Results

The tissue composition was very inhomogeneous containing fibrous, cartilaginous and bony tissue. Vessels were present in all investigated samples without a difference between the tissue from non-union and control patients. The growth factor BMP-2 was below the detection limit in all samples, whereas IL-6 and IGF-I were measured only in a few samples of both groups. TGF-ß1, VEGF-A and BMP-4 were detectable in the majority of the samples of both groups with a high variability in the amount but no difference between the groups. The quantity of both growth factors, BMP-7 and PDGF-AB, was significantly lower in the non-union tissue compared to the healed controls.

Conclusion

The reduced quantity of BMP-7 and PDGF-AB might be responsible for the impaired healing. Further studies analysing material from more patients and investigating the early healing phases, however, are necessary to obtain further information and consequently improve healing strategies.
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Metadata
Title
A pilot study investigating the histology and growth factor content of human non-union tissue
Authors
Philipp Schwabe
Paul Simon
Zienab Kronbach
Gerhard Schmidmaier
Britt Wildemann
Publication date
01-12-2014
Publisher
Springer Berlin Heidelberg
Published in
International Orthopaedics / Issue 12/2014
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI
https://doi.org/10.1007/s00264-014-2496-6

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